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A model of aggression in psychiatric hospitals
1Forensic Psychiatric Hospital De Kijvelanden, Poortugaal, the Netherlands.
Objective:
Research of the determinants of inpatient aggression indicates that certain environmental hospital variables play a role in triggering aggression in psychiatric hospitals. Yet, how patient, staff and ward variables interact in eliciting aggression is not well understood.
Method:
On the basis of earlier findings, a model was proposed in which psychopathology and distorted cognitions of the patient are combined with environmental and communicational stressors that are specific for psychiatric wards.
Results:
The proposed model elucidates how certain patient, staff and ward characteristics may interact in causing aggression. The model also emphasizes that repeated inpatient aggression may be the result of a vicious circle, i.e. inpatient violence is often followed by an increase in environmental and/or communication stress on the patient, thereby heightening the risk of a repeated outburst of violence.
Conclusion:
Although tentative, the model may shed light on the mechanisms that lead to (repeated) violence.